Sudden cardiac death and the potential role of beta-adrenoceptor-blocking drugs

Rajman, Iris; Kendall, M. J.

doi:10.1136/pgmj.69.818.903

Cited by 8 publications

(1 citation statement)

References 93 publications

(24 reference statements)

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“…However, in a post‐hoc analysis it was found that lower serum digoxin concentrations are associated with improved survival [31]. A clinically relevant reduction of the risk of sudden cardiac death could be demonstrated for β‐blocking agents alone [32 34].…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of Crataegus extract WS® 1442 in patients with heart failure: The SPICE trial

Holubarsch

Colucci

Meinertz

et al. 2008

European J of Heart Fail

101

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Background: Crataegus preparations have been used for centuries especially in Europe. To date, no proper data on their efficacy and safety as an add‐on‐treatment are available. Therefore a large morbidity/mortality trial was performed. Aim: To investigate the efficacy and safety of an add‐on treatment with Crataegus extract WS® 1442 in patients with congestive heart failure. Methods: In this randomised, double‐blind, placebo‐controlled multicenter study, adults with NYHA class II or III CHF and reduced left ventricular ejection fraction (LVEF≤35%) were included and received 900 mg/day WS® 1442 or placebo for 24 months. Primary endpoint was time until first cardiac event. Results: 2681 patients (WS® 1442: 1338; placebo: 1343) were randomised. Average time to first cardiac event was 620 days for WS® 1442 and 606 days for placebo (event rates: 27.9% and 28.9%, hazard ratio (HR): 0.95, 95% CI [0.82;1.10]; p=0.476). The trend for cardiac mortality reduction with WS® 1442 (9.7% at month 24; HR: 0.89 [0.73;1.09]) was not statistically significant (p=0.269). In the subgroup with LVEF ≥ 25%, WS® 1442 reduced sudden cardiac death by 39.7% (HR 0.59 [0.37;0.94] at month 24; p=0.025). Adverse events were comparable in both groups. Conclusions: In this study, WS® 1442 had no significant effect on the primary endpoint. WS® 1442 was safe to use in patients receiving optimal medication for heart failure. In addition, the data may indicate that WS® 1442 can potentially reduce the incidence of sudden cardiac death, at least in patients with less compromised left ventricular function.

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Section: Discussionmentioning

confidence: 99%